Symptomatology of gynecological diseases

With gynecological diseases, as with all other types of human pathology, changes (violations) of the functional state of various organs and systems can be observed. This is manifested by the relevant symptoms and complaints, which are considered in the propaedeutics of internal, surgical and other human diseases. However, the diseases of the woman's reproductive system are accompanied by a number of specific symptoms and complaints.

The most characteristic of them are violations of menstrual, sexual and genital functions, infertility, pathological secretion (leukemia), pain and violation of the function of adjacent organs. When evaluating menstrual function during the interview, it is necessary to find out the age of the appearance of the first menstruation, the length of the menstrual cycle, how many days menstruation lasts and how much blood is lost;

Whether the character of a menstrual cycle has changed after the beginning of a sexual life, abortions, sorts; When the last normal menstruation was; Whether the character of the menstrual cycle has changed in connection with this gynecological disease. If the patient has a climacteric, it is necessary to find out how it proceeds. Anomalies of menstrual function can arise as a consequence of not only gynecological, but also extragenital diseases or against the background of violations of the functions of the most important systems and organs without anatomical changes in the genital organs.

Now, in connection with the acceleration of puberty (acceleration), the first menstruation appears on average 11.5-13 years. Their earlier onset may indicate premature puberty. At the appearance of menstruation in 15 years and later you can think of infantilism. In most women, the menstrual cycle lasts 28-30 days. In some cases, this cycle is shortened (21-24 days) or elongated (over 30 days). It is important to evaluate the duration of menstruation and the amount of blood lost.

Usually menstruation lasts from 2 to 7 days the amount of blood lost - up to 200-250 ml. All the numerous violations of menstrual function can be reduced to the following main types: amenorrhea, hypomenstrual syndrome, hypermenstrual syndrome, menorrhagia, metrorrhagia and algodismenorea.

Amenorrhea - no monthly for more than 6 months. It can be physiological and pathological, primary and secondary.

Hypomencastral syndrome is expressed in the weakening, shortening and decreasing of menstruation (hypo-, oligo-, oposomenorea).

Hypermenstrual syndrome manifests itself in frequent, prolonged and profuse menstruation (poly-, hyper- and perimenorrhea).

Menorrhagia - bleeding associated with the menstrual cycle.

Metrorrhagia - acyclic, uterine bleeding, not associated with the menstrual cycle.

Algodismenorea - painful menstruation.

Ovulatory disorders - diseases with preservation of ovulation

Anovulatory disorders - diseases in the absence of ovulation.

Violations of sexual function are observed in a number of functional disorders and gynecological diseases. This part of the anamnesis to the intimate life of the patient, requires from the doctor the greatest measure. It is necessary to find out the time of the onset of sexual activity, sexual feeling (libido), satisfaction (orgasm). Their absence is often observed in infantilism, after severe general diseases and with some gynecological diseases. Painful sexual intercourse is one of the symptoms of inflammation of the uterine appendages and pelvic peritoneum.

Bloody discharge after sexual intercourse (contact bleeding) is a sign of cervical disease, often cervical cancer. It is necessary to find out the means and methods of contraception used by the patient. Unreasonable use of them can harm a woman's body. When collecting an anamnesis of genital function, the total number of pregnancies, their dates, course, outcome; The onset of the first pregnancy after the onset of sexual activity, the course of labor and the postpartum period; The presence of miscarriages, their nature (spontaneous, artificial), diseases associated with them. The onset of the first pregnancy 2 and more years after the marriage in the absence of contraceptive use means may indicate an underdevelopment of the genitals or other of sexual function.

Infertility after the first birth or miscarriage testifies to the transferred inflammation of the appendages of the uterus. The consequences of pathological birth and postpartum complications can be inflammatory diseases, traumas of soft tissues of the birth canal, anomalies of the position of the genital organs, and violations of menstrual function. Features of childbearing function are important in the diagnosis of neoplasms.

Cancer of the cervix is ​​more common in multiparous women, with cervical lesions. Myoma of the uterus is more common in low-birth or not giving birth to women. Pathological secretion (leucorrhoea) can be a manifestation of the disease of different parts of the genital organs. Beli can be either a symptom of gynecological diseases or a manifestation of pathological processes not directly related to the reproductive system. It is important to establish the source of increased secretion, which is necessary for diagnosis and treatment. Distinguish vestibular, vaginal, cervical, uterine and tubal leucorrhea.

Vestibular leukemia is most often caused by inflammatory processes of the external genitalia or large glands of the vestibule. The most common are vaginal leucorrhoea. A small amount of liquid contents of the vagina is a transudate from the blood and lymphatic vessels of the subepithelial layer, which, as it forms, dries or is absorbed back into the vaginal mucosa. These processes under normal conditions are balanced and therefore healthy women discharge from the vagina do not notice. The cause of the appearance of vaginal whites can be extragenital diseases (pulmonary tuberculosis, acute infectious diseases, hyperthyroidism), which result in a decrease in the hormonal function of the ovaries and the process of glycogen formation in the mucous membrane of the vagina.

The increased secretion of the vagina may be due to local infection, helminthic invasion, the presence of a foreign body in the vagina, the occurrence of genito-urinary and intestinal fistula. For practical purposes, a bacteriological study of vaginal discharge is carried out, which allows to determine the type of pathogen and to carry out targeted treatment.

Violation of the secretion of the glands of the cervix is ​​a fairly common cause of the origin of leucorrhoea. Cervical leucorrhoea often occurs with inflammation of the cervix, erosions, ruptures, polyps, cancer, tuberculosis of the cervix and other processes accompanied by ulceration uterine leucorrhoea can be caused by inflammation of the mucous membrane of the uterus (endometritis), submucous myoma, polyps of the mucosa, malignant tumors Relatively rare and are a consequence of the periodic outflow of fluid accumulated in the fallopian tube, through the hole in it first into the uterine cavity, and then into the vagina Causing the girdle Tubular bleaches may be malignant diseases, but more often inflammatory diseases of the tubes (serous or purulent) when the abdominal opening of the fallopian tube is closed. Often the main complaint of gynecological patients are pain.

The origin and nature of pain sensations are determined by the features of innervation of the genital organs, the state of the central nervous system, the nature of the disease (inflammatory processes, tumors, pregnancy disorders). Diseases of the genitals are often accompanied by a disorder of the lower part of the urinary tract, intestines. This is due to the anatomical proximity and interconnection of the nervous, vascular and lymphatic systems of sexual and neighboring organs.